During pregnancy, a woman’s body undergoes major changes which help support the growing baby. However, these changes also put extra strain on the heart. For women with existing heart problems — or those who develop them during pregnancy — this added stress can lead to complications.
“Understanding the risks as well as having a plan is the key to a successful pregnancy,” said Patricia Chavez, MD, a cardiologist with the Maternal Cardiac Program at Yale New Haven Health and an assistant professor of Medicine at Yale School of Medicine. “While most women with heart conditions can have healthy pregnancies, proper diagnosis is essential so that careful monitoring can be done to manage these conditions safely.”
Common Cardiac Conditions During Pregnancy
Several types of heart-related conditions may occur or worsen during pregnancy:
- Hypertensive disorders: Conditions like hypertension and ischemic heart disease are becoming more common due to older maternal age and lifestyle factors. They can increase strain on the heart and are linked to long-term cardiovascular risk.
- Hypercholesterolemia: High cholesterol levels may contribute to the development of heart disease and increase long-term risk for both mother and child.
- Myocardial infarction (heart attack): Although rare, pregnancy can increase the risk due to higher blood volume and clotting changes.
- Cardiomyopathies: These involve weakening of the heart muscle. A serious type, peripartum cardiomyopathy, occurs late in pregnancy or after delivery and can lead to heart failure.
- Arrhythmias: Irregular heartbeats may be triggered or worsened by pregnancy due to hormonal changes, increase blood volume and stress on the heart.
- Valvular disease: Women with known heart conditions such as valve problems may face higher risks during pregnancy because of increased blood flow.
- Thromboembolic disease: Pregnancy increases the risk of blood clots, which can travel to the lungs (pulmonary embolism) or brain.
- Aortic disease: Conditions affecting the large artery (aorta), such as aneurysm or dissection, can be dangerous due to increased pressure on blood vessels.
- Cerebrovascular diseases: These include stroke and other brain-related vascular problems, which can occur due to clotting changes or high blood pressure.
Warning Signs to Watch For
Although some discomforts such as mild shortness of breath or swelling are common in pregnancy, certain symptoms may signal a more serious problem:
- Persistent or severe shortness of breath
- Chest pain or tightness
- Rapid or irregular heartbeat
- Swelling in the legs or abdomen that worsens suddenly
- Extreme fatigue
- Dizziness or fainting
If any of these symptoms occur, you should contact your health care provider and get help right away. If you cannot reach your provider, go to the emergency room, said Dr. Chavez.
Managing Cardiac Health During Pregnancy
Regular prenatal care is key to identifying and managing cardiac issues early. Women with known heart conditions should ideally consult a healthcare provider before becoming pregnant to discuss risks and create a care plan. Lifestyle measures — such as maintaining a balanced diet, staying physically active as advised, and managing stress — also support cardiovascular health.
Treatment may include medications that are safe for pregnancy, monitoring through imaging or blood tests, and, in some cases, early delivery if the mother’s health is at risk.
The Maternal Cardiac Program offers comprehensive and individualized support before, during, and after pregnancy for people with heart conditions. The program brings together cardiologists, maternal-fetal medicine specialists, nutritionists, pharmacists, lactation consultants, social workers, and family planning specialists who utilize their unique expertise to provide comprehensive patient care. The multidisciplinary team meets regularly to create individualized care plans for each pregnant patient with heart disease.
“This allows us to assess health risks, optimize underlying medical conditions and establish a plan for the safest, healthiest possible pregnancy and delivery,” Dr. Chavez said.
Looking Ahead
With appropriate care, many women with pregnancy-related cardiac issues go on to have healthy pregnancies and recover well postpartum. Future fertility plans can be discussed to ensure a total cardiovascular recovery after pregnancy. Follow-up needs and the likelihood of late cardiovascular risk are also reviewed.
Awareness, early detection, and coordinated care between healthcare providers are the cornerstones of protecting both maternal and fetal health.
“Our goal is to empower women with the knowledge and confidence they need to navigate their health appointments and ensure their voices are heard,” Dr. Chavez said
